In this retrospective study, admissions for elective AAA and ruptured AAA (rAAA) were examined to assess possible changes in epidemiology and short-term mortality. 338,278 patients underwent elective repair of AAA and 47,524 (out of a total of 69,653) underwent repair of rAAA. Elective repair rates increased in those >80 years (57.7–92.3 per 100,000, P < 0.001) but decreased in those 65 to 74 years old (81.8–68.9, P < 0.001). A decline in ruptures with and without repair was seen in all age groups. 77% of elective repairs and 31% of all rupture repairs were performed with EVAR (P < 0.001). Operative mortality declined during the study period for elective (4.9%–2.4%, P < 0.001) and rAAA (44.1%–36.3%, P < 0.001) repairs. Short-term AAA-related deaths decreased by more than half (26.1–12.1 per 100,000, P < 0.001), with the greatest decline occurring in those > 80 years (53.7–27.3, P < 0.001).
Annals of Surgery 2012;256(4):651–658
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